Exercised-Induced Ischemic Colitis in a Recreational Athlete Previously Attributed to Inflammatory Bowel Disease

Abstract

Ischemic colitis traditionally presents in older patients, many whom have underlying atherosclerotic disease. Although symptoms may be transient and resolve spontaneously, serious complications may develop including stricture formation, bowel perforation, sepsis, or death. Recently, otherwise healthy athletes have been reported to develop ischemic colitis during or following strenuous, prolonged exercise. Here we describe a unique case in which a recreational athlete previously diagnosed with Crohns disease ten years prior presented with diarrhea and hematochezia attributed to an acute flare of her inflammatory bowel disease. Thorough review of her history, physical examination, laboratory, radiographic, and endoscopic evaluations revealed that her presenting symptoms were secondary to exercise-induced ischemic colitis. Moreover, her evaluation suggested that her prior diagnosis of Crohns disease was incorrect and that her previous Crohns flares were likely secondary to intermittent bouts of ischemic colitis. This case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities.




J Med Cases. 2012;3(6):379-382
doi: https://doi.org/10.4021/jmc839w